prevention of neural tube defect

^[1]^[2]

Management

Prevention:

folic acid 0.8-1 mg PO QD (begin 3 months before conception)
- little evidence that recommendation is working^[1]
avoid hot tubs during 1st trimester of pregnancy
- maternal temperature > 38.5 C increases risk of neural tube defects^[2]

↑ ^1.0 ^1.1 Journal Watch 25(11):87-88, 2005 Botto LD, Lisi A, Robert-Gnansia E, Erickson JD, Vollset SE, Mastroiacovo P, Botting B, Cocchi G, de Vigan C, de Walle H, Feijoo M, Irgens LM, McDonnell B, Merlob P, Ritvanen A, Scarano G, Siffel C, Metneki J, Stoll C, Smithells R, Goujard J. International retrospective cohort study of neural tube defects in relation to folic acid recommendations: are the recommendations working? BMJ. 2005 Mar 12;330(7491):571. Epub 2005 Feb 18. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/15722368 <Internet> http://bmj.bmjjournals.com/cgi/content/full/330/7491/571
↑ ^2.0 ^2.1 Suarez L et al, The effect of fever, febrile illness, and heat exposures on the risk of neural tube defects in a Texas-Mexico border population. Birth Defects Res A Clin Mol Teratol 70:815, 2005 PMID: https://www.ncbi.nlm.nih.gov/pubmed/15468073